24th  Annual Lake Benbrook Half Marathon/5K

January 28, 2012

8:30 am start

Direction:  I-30W to Hwy183S to Hwy377S turn left on Winscott Rd. and right into Dutch Branch Park.  I-20W to Hwy 183S to Winscott Rd. turn left and right into Dutch Branch Park.

Awards:  Overalls/3 deep age groups and trophy for the most School Team Participants

Last Name: First Name:

Age: Gender: Male Female T-Shirt: $2.00 extra for XXL

Event: 5K Fees: $20 by January 2, $25 until January 21, $30 until Jan. 28 Groups (5 or more) $15 by Jan.21.  

          Half Fees: $40 by January 2, $50 until January 21, $60 until January 28.  Groups (5 or more) $30 by Jan. 21

                                                                                                                                                                     Name of School/Group Team:Post marked by Jan.21,2012 

Street: City: State: Zip:

 Email (Optional)   Phone:

 Signature:__________________________________________________________________________

To be signed by the athlete and/or parent guardian of athletes if under 18  

Waiver Form: Sponsors and officials of the Lake Benbrook Half Marathon/5K to be held January 28, 2012 are not held responsible from all damages or injuries incurred during or arising out of my participation in this event.  Also, I certify that I am in sufficient physical condition to participate in this event  The City of Benbrook is not a sponsor of this event and is held harmless from all claims, suits, causes of action and liability arising out of the use and occupancy of all City of Benbrook park areas and facilities..

Packet pickup at Fort Worth Running Company 2701 W. 7th. Street,  January 26-28, 2012

Make checks payable to Lake Benbrook Half Marathon/5K                  Mail to 3619 Byers Ave., Fort Worth, Texas 76107